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Organization
NEW RIVER COTTAGE, INC.
Active
Organization
NEW RIVER COTTAGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DARLENE DOUGLAS MS (EXECUTIVE DIRECTOR)
(336) 372-5671
Entity
Organization
Contact information
Practice address
82 DAVIS LANE, SPARTA, NC 28675-0488
(336) 372-5671
(336) 372-5672
Mailing address
PO BOX 488, 82 DAVIS LANE, SPARTA, NC 28675-0488
(336) 372-5671
(336) 372-5672
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL003003
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MHL003003
—
NC
Enumeration date
08/03/2006
Last updated
08/22/2020
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